Barrett's esophagus is a rare disorder-affecting about one percent of adults in the U.S.-in which the lining of the esophagus (the tube, also called the food pipe, which carries food from the throat to the stomach) is damaged by stomach acid. Although the condition itself doesn't cause symptoms, the acid reflux that causes Barrett's esophagus frequently leads to heartburn and is commonly found in people with gastroesophageal reflux disease (GERD). In rare instances, Barrett's esophagus may develop into esophageal cancer.
Causes
When you eat, the food you put in your mouth passes down your throat to the stomach through the esophagus. Once the food is in your stomach, a ring of muscles keeps it from leaking backward into the esophagus. If the muscles don't close tightly, stomach acid can leak back, or reflux, into the esophagus. When this reflux damages the lining of the esophagus, it's referred to as Barrett's esophagus. The condition occurs more commonly in men than women, and is more likely to be found in people who have had GERD for a long time. In fact, treatment for GERD may prevent Barrett's esophagus from developing.
Signs and Tests
Because Barrett's esophagus itself doesn't cause symptoms, many doctors recommend that adults over 40 who have had GERD for many years undergo an endoscopy, a test in which a thin tube with a camera on the end is inserted through your mouth and passes into your esophagus and stomach. While the test is being performed, your doctor may take tissue biopsies from different parts of the esophagus to make a positive diagnosis of Barrett's and to look for changes that could lead to cancer.
Treatment
If a tissue biopsy shows cell changes in the esophagus, called high-grade dysplasia-which may lead to cancer-your doctor may recommend surgery or other procedures to remove the damaged tissue where the cancer is most likely to develop. Treatment may include:
- Surgery to remove most of the esophagus if you have severe dysplasia or cancer. A portion of the stomach is then pulled up into the chest and attached to the remaining portion of the esophagus.
- Photodynamic therapy, which involves the use of a laser device called an esophageal balloon along with a drug called Photofrin®.
- Other procedures using different types of high energy to destroy the precancerous tissue.
See your doctor if your heartburn symptoms last longer than a few days, if you have pain or difficulty swallowing, if your GERD symptoms get worse, or new symptoms such as weight loss or problems swallowing develop.
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